Explore articles covering clinical insights, research updates, conference highlights, and practical discussions in gastroenterology.
A 58-year-old man with Child-Pugh C alcoholic cirrhosis presents with low-grade fever, mild abdominal tenderness, and worsening encephalopathy. His ascites is long-standing, his last tap was six weeks ago, and his creatinine has crept up over 48 hours. Every finding points somewhere - and one of those somewhere-s is SBP. The clinical decision at this moment is not whether he has it. It's whether you are treating it fast enough.Spontaneous bacterial peritonitis diagnosis treatment decisions in cirrhosis carry a weight that the textbook PMN count does not fully convey. A 10–30% in-hospital mortality, a 70% one-year mortality without prophylaxis, and a risk of hepatorenal syndrome that rises sharply with delayed albumin - these are the stakes. Guidelines from EASL (2018) and AASLD are reasonably aligned on the core protocol, but the places clinicians go wrong are rarely the big decisions. They are the threshold edges, the albumin indications, and the distinction between primary and secondary prophylaxis.
April 23, 2026•By GastroAGI Team
You've completed a prospective study on H. pylori eradication failure rates in a tertiary care centre in India. The data is clean, the conclusions are solid, and now you face the question most clinicians skip thinking about until it's too late: where do I publish this? The wrong choice can cost your paper a year in review limbo, bury it behind a paywall your colleagues can't access, or worse - land it in a journal no one reads. This guide cuts through that confusion.
April 22, 2026•By GastroAGI Team
A 34-year-old vegetarian woman from Chennai presents with bloating, loose stools, and abdominal cramps for two years. Her colonoscopy is normal. Her H. pylori test is negative. You diagnose IBS-D - but you're treating her with protocols built almost entirely on Western microbiome data, in a patient whose gut flora has almost nothing in common with the cohorts those studies used. That gap is no longer just academic. This post maps what gut microbiome research in India has actually shown, where the critical unknowns remain, and how to use the emerging data in clinical practice today.
April 21, 2026•By GastroAGI Team
A 54-year-old woman with type 2 diabetes, BMI 33, and incidentally discovered elevated ALT returns to your clinic. Her FibroScan shows CAP 320 dB/m and liver stiffness of 9.8 kPa. She has tried and abandoned two weight-loss programs. She asks if there is finally a pill for this. For the first time in the 30-year history of NAFLD research, the honest answer is yes - but only if you sequence it correctly.The landscape of NAFLD and NASH treatment has fundamentally shifted since 2023. The nomenclature has moved - the field now formally prefers metabolic-associated steatotic liver disease (MASLD) - but more importantly, the therapeutic toolkit has expanded. Resmetirom received FDA approval in March 2024 as the first drug approved specifically for NASH with liver fibrosis, ending a long drought of failed trials. Simultaneously, GLP-1 receptor agonists have accumulated enough mechanistic and trial data to be used strategically. Despite this, the majority of patients with NAFLD/NASH still arrive in gastroenterology clinics without structured treatment plans - because the decision of who to treat, with what, and when remains genuinely complex. This post provides that framework.
April 20, 2026•By GastroAGI Team
You have a well-designed gastroenterology trial - a prospective cohort comparing fecal microbiota transplantation protocols in recurrent Clostridioides difficile, or a phase II drug trial in refractory IBD. The science is solid. The question everyone asks next is the one nobody teaches in fellowship: How do you actually get this approved in India? This guide walks through the IEC and CDSCO process for gastroenterology clinical trials - what to submit, in what order, and where most investigators lose months they could have saved.
April 16, 2026•By GastroAGI Team
A DM physician at a tier-2 hospital spends hours each week parsing conflicting treatment protocols for NAFLD — one from a US guideline body, another from a European liver society. Neither accounts for Indian dietary patterns, genetic predispositions, or the public-health context of a country carrying nearly 20% of the world's chronic liver disease burden. The answer, most of the time, isn't in a journal — it's on a conference floor in Varanasi, Amritsar, or New Delhi, where Indian gastroenterologists are producing and debating exactly that evidence. This post maps every major national conference where that work happens.
April 15, 2026•By GastroAGI Team
Fatigue in older adults is one of the most dismissed symptoms in medicine — and one of the most dangerous to ignore. Nearly one-third of people over 65 report significant fatigue, yet it's routinely chalked up to "just getting older." That assumption costs people years of quality life.Persistent fatigue is a signal, not a sentence. The biological mechanisms driving exhaustion in aging are increasingly well-understood — and many are treatable. Understanding where to draw the line between normal tiredness and a symptom worth pursuing starts at the cellular level.
April 14, 2026•By GastroAGI Team
A 34-year-old woman with no prior liver disease presents with her first episode of severe alcoholic hepatitis — Maddrey's Discriminant Function of 68, MELD 28, non-responsive to corticosteroids at day 7. Her family is engaged, she has no prior treatment history, and she is asking the right questions. Your medical options are effectively exhausted. She will likely be dead in weeks. The question is not whether she deserves a transplant. The question is whether a number - six months - should decide that for you.
April 9, 2026•By GastroAGI Team
A 58-year-old woman is admitted with her first episode of acute pancreatitis. Gallstones are the cause. Her initial SIRS criteria are met on two counts, and her creatinine is creeping up. She looks uncomfortable but not critically ill. The question isn't whether she has pancreatitis — it's whether she's about to declare severe disease, whether you should be scanning her now, and whether she'll need a drain or an OR before this admission ends. That decision tree is what this post is built around.
April 7, 2026•By GastroAGI Team
A 58-year-old man with known alcohol-related cirrhosis is admitted with jaundice, confusion, and a bilirubin of 18 mg/dL. Three beds down, a 24-year-old woman with no liver history presents with the same triad — jaundice, encephalopathy, bilirubin of 22 mg/dL — after two weeks of paracetamol overuse. Both patients look critically unwell. Both will be labelled "liver failure" in the initial clerking note. But the diagnosis, prognosis, and management for these two patients are so fundamentally different that conflating them is one of the more consequential errors in hepatology.The distinction between acute-on-chronic liver failure and acute liver failure matters not just academically but at every decision point: who gets admitted to the ICU, who gets listed for transplant, which vasopressors are appropriate, how long you wait before escalating. The challenge is that on a busy admissions ward, the two can look identical for the first few hours. Both present with jaundice, encephalopathy, and coagulopathy. Both can deteriorate within 24 hours. And the underlying liver disease in ACLF may never have been formally diagnosed before. This post is specifically about the diagnostic framework that separates them — and what changes downstream once you get it right.
April 6, 2026•By GastroAGI Team
Overview
Overview
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